Ann I Scher1, G Webster Ross2, Sigurdur Sigurdsson2, Melissa Garcia2, Larus S Gudmundsson2, Sigurlaug Sveinbjörnsdóttir2, Amy K Wagner2, Vilmundur Gudnason2, Lenore J Launer2. 1. From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA. ascher@usuhs.mil. 2. From the Department of Preventive Medicine and Biometrics (A.I.S.), Uniformed Services University, Bethesda; National Institute on Aging (A.I.S., M.G., L.J.L.), Laboratory of Epidemiology and Population Sciences, Bethesda, MD; Veterans Affairs Pacific Islands Health Care System (G.W.R.), Honolulu; Pacific Health Research & Education Institute (G.W.R.), Honolulu, HI; Icelandic Heart Association (S. Sigurdsson, V.G.), Kopavogur; School of Health Sciences (L.S.G.) and Faculty of Medicine (V.G.), University of Iceland, Reykjavik; Department of Neurology (S. Sveinbjörnsdóttir), Broomfield Hospital, UK; and Department of Physical Medicine and Rehabilitation (A.K.W.), University of Pittsburgh, PA.
Abstract
OBJECTIVE: In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). METHODS: The AGES-Reykjavik cohort (born 1907-1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. RESULTS: Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7-4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2-5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3-4.0]) or sibling (ORMA = 1.78 [95% CI 1.1-2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. CONCLUSIONS: These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms.
OBJECTIVE: In the present study, we tested the hypothesis that having migraine in middle age is related to late-life parkinsonism and a related disorder, restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED). METHODS: The AGES-Reykjavik cohort (born 1907-1935) has been followed since 1967. Headaches were classified based on symptoms assessed in middle age. From 2002 to 2006, 5,764 participants were reexamined to assess symptoms of parkinsonism, diagnosis of Parkinson disease (PD), family history of PD, and RLS/WED. RESULTS: Subjects with midlife migraine, particularly migraine with aura (MA), were in later life more likely than others to report parkinsonian symptoms (odds ratio [OR]MA = 3.6 [95% CI 2.7-4.8]) and diagnosed PD (ORMA = 2.5 [95% CI 1.2-5.2]). Women with MA were more likely than others to have a parent (ORMA = 2.26 [95% CI 1.3-4.0]) or sibling (ORMA = 1.78 [95% CI 1.1-2.9]) with PD. Late-life RLS/WED was increased for headache generally. Associations were independent of cardiovascular disease and MRI-evident presumed ischemic lesions. CONCLUSIONS: These findings suggest there may be a common vulnerability to, or consequences of, migraine and multiple indicators of parkinsonism. Additional genetic and longitudinal observational studies are needed to identify candidate pathways that may account for the comorbid constellation of symptoms.
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